Dental developmental abnormalities in a patient with subtelomeric 7q36 deletion syndrome may confirm a novel role for the SHH gene.

Studies in mice demonstrated that the Shh gene is crucial for normal development of both incisors and molars, causing a severe retardation in tooth growth, which leads to abnormal placement of the tooth in the jaw and disrupted tooth morphogenesis. In humans the SHH gene is located on chromosome 7q36. Defects in its protein or signaling pathway may cause holoprosencephaly spectrum, a disorder in which the developing forebrain fails to correctly separate into right and left hemispheres and that can be manifested in microforms such as single maxillary central incisor. A novel role for this gene in the developing human primary dentition was recently demonstrated. We report a 12-year old boy with a de novo 7q36.1-qter deletion characterized by high-resolution karyotyping, oligonucleotide aCGH and FISH. His phenotype includes intellectual disability, non-verbal communication, hypospadia, partial sacral agenesis and absence of coccyx, which are distinctive features of the syndrome and mainly correlated with the MNX1, HTR5A and EN2 genes. No microforms of holoprosencephaly spectrum were observed; but the patient had diastema and dental developmental abnormalities, such as conical, asymmetric and tapered inferior central incisors. The dental anomalies are reported herein for the first time in subtelomeric 7q36 deletion syndrome and may confirm clinically a novel role for the SHH gene in dental development.

Comparison between conducted healing and the use of skin grafts for the treatment of skin wounds in rabbits.

BACKGROUND: Improvement of the healing process to provide better aesthetical and functional results continues to be a surgical challenge. This study compared the treatment of skin wounds by means of conducted healing (an original method of treatment by secondary healing) and by the use of autogenous skin grafts. MATERIAL AND METHODS: Two skin segments, one on each side of the dorsum, were removed from 17 rabbits. The side that served as a graft donor site was left open as to undergo conducted healing (A) and was submitted only to débridement and local care with dressings. The skin removed from the side mentioned above was implanted as a graft (B) to cover the wound on the other side. Thus, each animal received the two types of treatment on its dorsum (A and B). The rabbits were divided into two groups according to the size of the wounds: Group 1--A and B (4cm2) and Group 2--A and B (25cm2). The healing time was 19 days for Group 1 and 35 days for Group 2. The final macro- and microscopic aspects of the healing process were analyzed comparatively among all subgroups. The presence of inflammatory cells, epidermal cysts and of giant cells was evaluated. RESULTS: No macroscopic or microscopic differences were observed while comparing the wounds that underwent conducted healing and those in which grafting was employed, although the wounds submitted to conducted healing healed more rapidly. CONCLUSION: Conducted wound healing was effective for the treatment of skin wounds.

Morfologia e resistência cicatriciais da parede abdominal após laparotomias longitudinal e transversal em coelhos / Abdominal wall morphology and healing resistance after longitudinal and transversal laparatomy in rabbits

OBJETIVO: Foram estudadas comparativamente as laparotomias longitudinais paramediana e transversal avaliando-se a resistência cicatricial da parede abdominal e seu aspecto histológico, com peritônio suturado ou não. MÉTODO: 30 coelhos foram distribuídos em dois grupos: Grupo 1 (n = 10) - laparotomia longitudinal, Subgrupo 1A (n = 5) sutura das bainhas anterior e posterior do músculo reto abdominal, bem como do peritônio, Subgrupo 1B (n = 5) sutura da bainha anterior do músculo reto abdominal. Grupo 2 (n = 20) - laparotomia transversa, Subgrupo 2A (n = 5) sutura das bainhas anterior e posterior do músculo reto abdominal, bem como do peritônio, Subgrupo 2B (n = 5) sutura apenas da bainha anterior do músculo reto abdominal, Subgrupo 2C (n = 5) sutura, em plano único, do músculo reto abdominal e de sua bainha anterior, Subgrupo 2D (n = 5) síntese, da bainha posterior do músculo reto abdominal junto com o peritônio e, em seguida, sutura do músculo reto abdominal, complementada por sutura da bainha anterior desse músculo. Após 17 dias, foram retirados dois segmentos peritonio-aponeurotico-musculares da cicatriz para avaliação da resistência e de seus aspectos histológicos. RESULTADOS: O valor da resistência para cada um dos grupos avaliados mostrou 1A > 1B, 1A > 2A e 1B > 2B, e 2B > 2C > 2D > 2A (p = 0,014). Deiscência, infecção e aderências foram mais freqüentes no Grupo 2. A histologia mostrou degeneração e necrose muscular, com sua substituição por tecido conjuntivo fibroso maduro cicatricial. CONCLUSÃO: Esses dados indicam que o corte muscular transversal provoca maior enfraquecimento muscular e que o peritônio deixado aberto não altera a resistência cicatricial.

BACKGROUND: The abdominal wall is a main topic of investigation in terms of its healing. The purpose of this investigation was to assess the healing of transverse and longitudinal laparotomies. METHODS: Thirty rabbits were distributed into two groups: Group 1 (n = 10) longitudinal laparotomy, Subgroup 1A (n = 5) suture of the anterior and posterior sheaths of the abdominal rectal muscle and peritoneum, Subgroup 1B (n = 5) suture of the anterior abdominal rectal muscle sheath. Group 2 (n = 20) transverse laparotomy, Subgroup 2A (n = 5) suture of the anterior and posterior sheaths of the rectal muscle and peritoneum, Subgroup 2B (n = 5) suture of only the anterior rectal muscle sheath, Subgroup 2C (n = 5) suture of the anterior rectal muscle sheath of the, Subgroup 2D (n = 5) suture of the anterior and posterior rectal muscle sheaths, including the peritoneum. After 17 days, two peritoneal-aponeurotic-muscle segments with the scar were removed in order to verify their resistance and histological aspects. RESULTS: The resistance values detected on each group showed 1A > 1B, 1A > 2A and 1B > 2B, and 2B > 2C > 2D > 2A (p = 0.014). Dehiscence, infections and adhesions were more frequent in Group 2. Histology revealed muscle degeneration and necrosis, with mature fibrous connective scar tissue replacing the muscle. CONCLUSION: Transverse muscle section provokes a greater muscle weakening; the peritoneum closure does not modify the scar resistance.

[Guided healing and skin graft for the treatment of skin wounds]. / Cicatrização conduzida e enxerto de pele parcial no tratamento de feridas.

OBJECTIVE: The present study compared the treatment of skin wounds by means of conducted healing (an innovative method for treatment of secondary healing) and autogenous skin graft. METHODS: Seventeen rabbits were submitted to removal of two skin segments, one on each side of the dorsum. The graft donor area was left as a wound for conducted healing (A) and was submitted only to debridement, local care and dressings. The skin removed from the above mentioned side was implanted as a graft (B) to cover the wound on the other side. Thus, each animal received the two types of treatment on its dorsum (A and B). Rabbits were divided into two groups according to size of the wounds: Group 1--A and B (4 cm2) and Group 2--A and B (25 cm2). Healing time was of 19 days for Group 1 and of 35 days for Group 2. The final macro- and microscopic aspects of healing were comparatively analyzed in the four subgroups. Presence of inflammatory cells, of epidermal cysts and of giant cells was assessed by histology. Data were statistically analyzed by the nonparametric Fisher, Kruskal-Wallis and Wilcoxon tests. RESULTS: No macro- or microscopic difference was observed between conducted healing and skin graft, although conducted healing led to a more rapid wound healing. CONCLUSION: Conducted healing seems to be a good therapeutic option for skin wounds in rabbits.

Cicatrização conduzida e enxerto de pele parcial no tratamento de feridas / Conducted healing and skin graft for the treatment of skin wounds

OBJETIVO: Avaliar comparativamente os tratamentos para área cruenta da pele por meio de cicatrização conduzida (método original de cicatrização cutânea por segunda intenção) e enxerto de pele autógena. MÉTODOS: Foram utilizados 17 coelhos, dos quais foram retirados dois segmentos de pele, um de cada lado do dorso. De um lado, a área doadora do enxerto permaneceu cruenta, para cicatrização conduzida (A). Do outro lado do dorso, a pele foi implantada como enxerto (B), para recobrir a área cruenta. Assim, cada animal tinha em seu dorso os dois tipos de tratamentos (A e B). Os coelhos foram distribuídos em dois grupos, de acordo com o tamanho das feridas provocadas em seu dorso: grupo 1 - A e B (4 cm²) e grupo 2 - A e B (25 cm²). Avaliou-se o tempo de cicatrização de ambos os tratamentos: grupo 1, após 19 dias, e grupo 2, após 35 dias. Os aspectos macro e microscópico finais da cicatrização foram analisados comparativamente nos quatro subgrupos. A histologia, avaliaram-se o número e a espessura de estratos da epiderme, a presença de células inflamatórias, bem como de cistos epidérmicos e de células gigantes. O estudo estatístico usou os testes não paramétricos de Fischer, Kruskall-Wallis e Wilcoxon. RESULTADOS: Não se observou diferença macro ou microscópica entre a cicatrização conduzida e o enxerto de pele. CONCLUSÃO: A cicatrização conduzida parece ser uma boa opção terapêutica para áreas cruentas cutâneas em coelhos.

OBJECTIVE: The present study compared the treatment of skin wounds by means of conducted healing (an innovative method for treatment of secondary healing) and autogenous skin graft. METHODS: Seventeen rabbits were submitted to removal of two skin segments, one on each side of the dorsum. The graft donor area was left as a wound for conducted healing (A) and was submitted only to debridement, local care and dressings. The skin removed from the above mentioned side was implanted as a graft (B) to cover the wound on the other side. Thus, each animal received the two types of treatment on its dorsum (A and B). Rabbits were divided into two groups according to size of the wounds: Group 1 - A and B (4 cm²) and Group 2 - A and B (25 cm²). Healing time was of 19 days for Group 1 and of 35 days for Group 2. The final macro- and microscopic aspects of healing were comparatively analyzed in the four subgroups. Presence of inflammatory cells, of epidermal cysts and of giant cells was assessed by histology. Data were statistically analyzed by the nonparametric Fisher, Kruskal-Wallis and Wilcoxon tests. RESULTS: No macro- or microscopic difference was observed between conducted healing and skin graft, although conducted healing led to a more rapid wound healing. CONCLUSION: Conducted healing seems to be a good therapeutic option for skin wounds in rabbits.

Mostre seu filho / Show your son

Mostrar? Mostrar o filho? Afinal, do que se trata? A sociedade parece, as vezes, ignorar, desconhecer, ou mesmo, tentar minimizar (como se isto fosse possível) os problemas daqueles que enfrentam o processo da deficiência. Era preciso que algo, de alguma forma, arrancasse da imobilidade mente e coraçöes. O brado das mäes e pais, curtidos na dor e no sofrimento, movimentou coraçöes sensíveis para a criaçäo de uma Coordenadoria Estadual de Pais de Pessoas Portadoras de Deficiência, na Secretaria de Estado da Saúde. Os pais desejam, veementemente, encontrar-se e trocar experiências para ajuda mútua, descerrando, assim, portas, caminhos corretos, necessários e humanos para o desenvolvimento de seus filhos. "Mostre seu filho", mostre seu coraçäo, mostre sua solidariedade. Este livro, com certeza, vai sacudir a indiferença, a fuga, o abandono e amenizar o sofrimento que enfrentam muitas famílias quando näo ajudadas. Leia "Mostre seu filho"! Voce vai emocionar-se e, até mesmo, pode chorar. "Mostre seu filho" motivará, certamente, a formaçäo de uma gigantesca "corrente de solidariedade", cujo objetivo é abrir espaço, na sociedade, para o próximo, filho, irmäo, pai e todas aquelas pessoas portadoras de deficiência sem esperança de futuro.

Anestésicos locais / Local anesthetics

Os autores estudaram as possíveis complicações com o uso rotineiro dos anestésicos locais na clínica médica e odontológica e mostraram como prevenir tais acontecimentos